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Adverse reactions following diethylcarbamazine (DEC) intake in 'endemic normals', microfilaraemics and elephantiasis

M Haarbrink1, A J Terhell, G K Abadi

  • 1Department of Parasitology, Leiden University Medical Centre, The Netherlands.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|September 24, 1999
PubMed

Insights

High microfilarial loads increase the risk of severe adverse reactions to diethylcarbamazine (DEC) in brugian filariasis patients. This finding is crucial for managing filariasis treatment safely and effectively.

Area of Science:

  • Tropical Medicine
  • Parasitology
  • Pharmacology

Background:

  • Brugian filariasis is a significant public health problem in Indonesia.
  • Diethylcarbamazine (DEC) is a primary drug for treating filariasis, but adverse reactions can occur.
  • Understanding factors influencing DEC adverse reactions is vital for patient safety.

Purpose of the Study:

  • To investigate the relationship between pre-treatment microfilarial load and the severity of adverse reactions to DEC in brugian filariasis patients.
  • To assess adverse reactions in different patient groups including microfilaria-positive individuals, endemic normals, and elephantiasis patients.

Main Methods:

  • A 12-day course of 6 mg/kg DEC was administered to 26 microfilaria-positive individuals, 12 endemic normals, and 17 elephantiasis patients.
  • Adverse reactions were categorized as 'no or mild', 'moderate', or 'severe' based on a reaction score.
  • Pre-treatment microfilarial levels were measured and compared between groups with different reaction severities.

Main Results:

  • Four (15.4%) microfilaraemic individuals experienced severe adverse reactions, with significantly higher pre-treatment microfilarial levels (GM = 3060 mf/10 mL) compared to those with moderate (GM = 1268 mf/10 mL) or mild reactions (GM = 6 mf/10 mL).
  • Endemic normals and most elephantiasis patients reported no or mild adverse reactions.
  • Two elephantiasis patients with moderate reactions had high pre-treatment microfilarial loads (2097 and 7375 mf/10 mL).
  • Plasma DEC concentrations did not explain the observed differences in reaction severity.

Conclusions:

  • Pre-treatment microfilarial load is a significant predictor of severe adverse reactions to DEC in brugian filariasis.
  • Patients with higher microfilarial loads are at greater risk for severe reactions, necessitating careful monitoring during DEC therapy.
  • Further research may explore preemptive strategies for high-risk individuals to mitigate adverse events during filariasis treatment.

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